Neurodevelopmental assessments: the right to choose a service

 

Following updated advice from NHS England, people referred for an assessment for a neurodevelopmental condition now have a legal right to choose who provides this service.

Neurodevelopmental conditions include Autism and Attention Deficit Hyperactivity Disorder (ADHD).

This updated advice applies to assessments for both children and adults.

 

Patient choice

Under the NHS Choice Framework (also known as ‘Patient Choice’), there is a right to choose when:

 

• A GP decides with you to make a referral for assessment or treatment;

• The waiting time for a service is longer than 18 weeks; or

• You were not offered a choice by the GP when first referred.

 
Choosing a service

You can choose to be referred to a locally commissioned service or any service provider in England that:

 

• Your GP agrees is appropriate

• Is led by a health care professional

• Has a contract with any clinical commissioning group (CCG) or NHS England.

 
Further information

See Appendix 1 on legal questions, and Appendix 2 with details of locally commissioned providers. Please note that other providers not on this list may be considered by a GP, if they have an NHS contract.

For more general information about Patient Choice see: The NHS Choice Framework: what choices are available to me in the NHS? – GOV.UK (www.gov.uk)

For information about how patient choice applies to mental health services (including assessments for neurodevelopmental conditions) see NHS England’s Choice in Mental Health Guidance.

 
Appendix 1: Legal Q&A

This information is taken from the Society for Neurodiversity guide on ‘Right to choice’ which explains more about the patient choice regulations and the duties of Clinical Commissioning Groups.

Q: If I want an NHS funded assessment, do I have to go to a service commissioned by my local CCG?

A: No. You can choose any provider that has a contract with any CCG or NHS England.

 

Q: I’ve been referred for an assessment but have been on a waiting list for more than 18 weeks. Can I ask my GP to refer me to a different provider?

A: Yes. You can decide with your GP which service would be appropriate for you. You can choose any provider that has a contract with any CCG or NHS England.

 

Q: When referred for assessment, I wasn’t offered a choice of services. Can I now ask my GP to refer me to different provider?

A: Yes. You can decide with your GP which service would be appropriate for you. You can choose any provider that has a contract with any CCG or NHS England.

 

Q: Can I self-refer to a provider of my choice?

A: No. A GP has to make a referral, based on a joint decision with you.

 

Q: Does my referral have to go through the First Point of Access (FPoC) or a Single Point of Access (SPA)?

A: No. This is because under patient choice rules, the decision to refer is made by a GP. A Single Point of Access (or First Point of Access) should not restrict patient choice.

 

Q: Can I only choose a service that is led by a consultant?

A: No. Patient choice rules say a service must be led by a consultant or other health professional.

 

Q: Does my choice of service have to be fully NICE compliant or registered with the CQC?

A: No. NICE guidelines are not mandatory. If not NICE compliant, however, it would be important to show that a referral is appropriate to an individual’s circumstances, and that a choice has been made in consultation with them and their family or carers.

Not all service providers have to be registered with the CQC, but it is worth contacting the provider to check.

 

Q: Can a referral be refused on the grounds of cost?

A: No. Patient choice rules do not say that choice can be restricted by cost.

If a patient choice request is declined, the NAS branch can help you to seek advice from NHS England.

 
Appendix 2: List of locally commissioned ASD/ADHD providers*
 
Adults:

• South West Yorkshire Partnership Foundation Trust (Adults with Autism Service)

• Bradford District Care NHS Foundation Trust (Bradford/Airedale Neurodevelopmental Service BANDS)

• Greater Manchester Mental Health NHS foundation Trust (GMMH)

• Sheffield Health and Social Care NHS Foundation Trust (Sheffield Adult Autism and Neurodevelopmental Service SAANS)

• Learning Assessment & Neurocare Centre (LANCuk) www.lanc.org.uk

 
Children & Young People:

• South West Yorkshire Partnership Foundation Trust

• Mid Yorkshire Hospitals NHS Trust

Pennine Care NHS Foundation Trust

The Oakdale Centre

• Butterfly Psychology

Daisy Psychology

• Charlotte Wade

*As contracts may expire, check that the provider has a current NHS (commissioned by a CCG or NHSE) contract to provide the relevant service.

Please note that other providers not on this list may be considered by a GP, if they have an NHS contract.